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NPI Code Detail

MEDICARE: MR. CHRISTOPHER JOHN WERKLEY MSW, LICSW, BCD

MEDICARE:  MR. CHRISTOPHER JOHN WERKLEY  MSW, LICSW, BCD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker1834ND

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2011939OTHERNDBCBS ND PROVIDER NUMBER
350B58WEOTHERMNBCBS MN PROVIDER NUMBER

General Provider Information

NPI Number : 1447299417
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CHRISTOPHER JOHN WERKLEY MSW, LICSW, BCD
Provider Business Mailing Address
First Line : 151 S 4TH ST
Second Line : SUITE 401
City : GRAND FORKS
State : ND
Zip : 58201-4715
Country : US
Telephone Number : 701-795-3000
Fax Number : 701-795-3050
Provider Business Practice Location Address
First Line : 151 S 4TH ST
Second Line : SUITE 401
City : GRAND FORKS
State : ND
Zip : 58201-4715
Country : US
Telephone Number : 701-795-3000
Fax Number : 701-795-3050
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2006
Last Update Date : 07/09/2007

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Directions to “ MR. CHRISTOPHER JOHN WERKLEY MSW, LICSW, BCD” Practice Location

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